Individual
MR. KENT BERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
8424 NAAB ROAD BUILDING 1, SUITE 1L, INDIANAPOLIS, IN 46260
(317) 338-7780
Mailing address
8424 NAAB ROAD BUILDING 1, SUITE 1L, INDIANAPOLIS, IN 46260-1954
(317) 338-7780
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20042675A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200077810A
—
IN
Enumeration date
12/03/2013
Last updated
05/24/2022
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